It was a pleasure to have POS Instructor Dr. Richard Richter visit us at POS Headquarters all the way from New York. In this interview, he sits down with POS CEO Miles McGann to share why a multidisciplinary approach to dentistry is crucial to provide patients with the best care.
MILES MCGANN: Today I have Dr. Richard Richter from New York here with us. He's a good friend who's been teaching for POS since about the mid 2000s, I believe, so quite a bit of history. He does a lot of lasers, does a lot of TMD, has a very nice multidisciplinary practice in the Hamptons and I think he brings a lot of expertise to the table. So welcome Richard. Thanks for coming out. So Richard, first of all tell me a little bit how you got into doing ortho.
DR. RICHARD RICHTER: Well, that's an interesting story. There was actually an orthodontist in the area who was competing for my business, so he invited me to lunch. I brought two cases with me and one was a simple expansion case and the other a molar uprighting case. I showed him the cases and he looked at me he said, “Richard you should be doing this. Go learn some ortho. This is not what I want you to send me.”
MILES: So an orthodontist told you this? Wow, that's maybe the first time I've a heard story like this one.
DR. RICHTER: So I took what he said to heart and I decided to search out and learn ortho.
MILES: Nice, that's an honest guy. How did you pick POS?
DR. RICHTER: Okay so that's an adventure. I took a few of these weekend courses in ortho and I left realizing I didn't learn ortho. Then Invisalign came knocking on my door when they first opened it up to GPs back then. I took the Invisalign program and I realized I didn't learn any ortho. So then I decided no more quick fix and I came across POS. There was another big program at the time too. I ordered the syllabus for both. I wanted the longest, most comprehensive program I could find. That was POS.
MILES: Yeah, a lot of instructors and a lot of POS students I've heard say the same thing of I didn't want to take a shortcut because I knew it would get me in trouble, so give me the most comprehensive program. Give me the one that teaches me everything I need to know so I know what I'm doing. Do you still do Invisalign? Or aligners? I'll leave it as aligners.
DR. RICHTER: Yes, I do clear aligners in a small percentage of cases. Like I tell all the doctors that attend the program who are doing Invisalign, Invisalign is just a tool. It's like one of your instruments in your bag. You need the ortho knowledge to know when you can use it and when you can't use it. A lot of doctors take these programs thinking that's the end all and they get into trouble.
MILES: So there's a lot of orthodontic techniques that you can use that in the right context make sense, but the tricky part in your opinion, is knowing case selection and knowing the limitations of each one of your tools. Making sure you have something in your toolbox long-term, where if it doesn't work out, you can get yourself out of that mess.
DR. RICHTER: Yeah, and you need enough knowledge to know which tool not to take out of the bag.
MILES: Tell me a little bit about your practice.
DR. RICHTER: It's a comprehensive practice, meaning we try and do everything. It's a total care philosophy including, of course, orthodontics and as you know a lot of TMJ dysfunction cases. We do sleep apnea appliance fabrication, perio, laser care, we do everything.
MILES: Right, and I know you're a big proponent of a comprehensive care model. I know you're also big CE junkie where you've taken almost every CE course you can think of, so that you do offer your patients all kinds of services and can plan that way as well. Tell me more about your philosophy, why do you think that's so important?
DR. RICHTER: Well it's kind of what I teach in the POS Intro seminars, why I want the doctors to take the POS program is you can't, especially in today's day and age but I feel like it's always been true, you can't have a patient walk in the door and not have a periodontal, an endo, a prosth, implant, ortho, TMD, everything organized into one treatment plan for them. If you lose out, if you miss one of those steps, you can sink the ship.
MILES: Right, and so having that perspective, one of the advantages of being a GP is having that perspective. You can step back and see the big picture and make sure every piece of that case is being considered. Whether or not you're doing it, in order to give the patient the best treatment. That's kind of the role in your opinion of a GP versus a specialist and how the system is supposed to work.
DR. RICHTER: Yeah, I kind of like to look at the GP as the super specialist because we have to know everything. Even if we are going to refer a certain section out, you have to have enough knowledge to plan it.
MILES: So you're a big time TMJ guy. You're teaching a TMJ class coming up in New York, I believe. Tell me a little bit about that class.
DR. RICHTER: The class is going to combine both TMJ management along with sleep apnea treatment. The thing that I want the doctors to be able to do is to go home and immediately start to treat both TMD and sleep apnea. I want them to understand that you can't do one without the other. There's a lot of sleep apnea patients that might be referred your way from a sleep specialist or a pulmonologist and you have to know enough about TMD to recognize that you have to treat that also otherwise you fit them with the appliance you make them worse and then it ends up in a desk drawer. Likewise you have a lot of TMD patients who come in to you and many of them also have sleep apnea so the door swings both ways. You need to know everything, or rather enough about each treatment modality to understand that they're interconnected.
MILES: Correct, so I assume in your class you will be talking a lot about diagnosis since I know your philosophy has always been if I know what's happening before I start I'm going to be better prepared and have less surprises. So you'll talk the diagnosis of both sleep apnea and TMJ as well as the different treatment options and I'd imagine review of almost all the treatment options so that the person is understanding what's possible. And then are you going to go through all different appliances and give recommendations on appliances?
DR. RICHTER: Yeah, we're going to cover a lot of different appliance types and when each appliance would be more beneficial depending on the case type that comes in.
MILES: Are you going to have time for any of the multidisciplinary? How TMJ fits with ortho or any of those kind of things too?
DR. RICHTER: Absolutely ortho ties into everything that I do so you can rest assured that's going to be part of the treatment discussions.
MILES: Can you imagine doing dentistry without ortho?
DR. RICHTER: No, I can't. Actually I can't.
MILES: Yeah, I have always said even if you don't do the ortho yourself, that hole in your education is so big because in a multidisciplinary practice ortho is a foundation piece to every case.
DR. RICHTER: Miles, once I took the POS program myself I equated it to someone who's colorblind all of a sudden being able to see color. That that's the type of blinders we have on regarding our orthodontic education.
MILES: I can imagine. Long term, where do you see the profession going, or even in the short term? I know you're very opinionated because you have a lot of experience so you've seen a lot of change in the industry. You've always been very cutting edge. I remember you taught a class many years ago about technology and you were one of the guys that went through and looked at every piece of technology, every CEREC machine , any new thing that came out you were the early adapter guy that jumped in there and bought it so I think you have an interesting perspective of what's possible in the future and where you see things going.
DR. RICHTER: Yeah, right now everything seems to be internet and cell phones and streaming and mobile sites and I see a lot of the young doctors are so geared towards this. I think that's where a lot of our education is going to begin to at least drift over in part to, which is why SmileStream is a wonderful tool and IAT is a great educational option for the doctors so you have the best of all worlds available for you. I definitely see the whole profession gearing up more towards the computerized end, tech wise, clinically, and educationally.
MILES: Your daughter is a dentist. She's currently taking POS.
DR. RICHTER: She's currently in the class. She's currently on maternity leave also.
MILES: With your experience with her, what advice have you given to her and I guess in essence to young dentists starting out today? Because she's a new dentist that's coming into the profession with the advantage of having a father that's been through it all and can guide her the right way.
DR. RICHTER: I would have to say that we talk about the comprehensive care part. When I started out as a dentist, I knew nothing about ortho, for example. There was really very little out there in terms of TMD education. I actually got started in that years ago because my sister suffered with it miserably when I was in dental school so I had to learn as much as I could about it. I think that the young dentists coming out of dental school today have an opportunity, especially with access to the Internet Assisted Training. Learn as much as you can about all the specialties because you can't treatment plan properly unless you're educated in all the specialties.
MILES: Makes perfect sense to me. Thank you so much. I appreciate you coming out.
